By Todd H. Baron MD FASGE, Richard A. Kozarek MD FASGE, David Leslie Carr-Locke MD FRCP FACG FASGE
ERCP, now in its moment variation, is devoted to simplifying and explaining every little thing you need to be aware of to successfully and accurately perform endoscopic retrograde cholangiopancreatography. top quality pictures, illustrative diagrams, and assurance of the newest thoughts consultant you thru this complicated subject and assist you in attaining optimum outcomes.
- Deliver the simplest therapy
- Master the newest diagnostic and healing ideas with ERCP - your visual and interactive guide to this more and more very important procedure!
with an in-depth assessment of problematic ERCP tactics, and equip your self with the latest strategies, healing modalities, and guidelines.
- Apply the newest ERCP techniques
- Enhance your learning with assistance from summaries following each one bankruptcy, up to date pictures all through, and a wealth of illustrative diagrams demonstrating key information.
- See how it is done. Over 40 videos characteristic the newest approaches, akin to Needle Knife Sphincterotomy, Biliary Sphincterotomy, Cannulation, and Fistulotomy.
- Access the absolutely searchable textual content, obtain all of the photos, and watch key movies online at www.expertconsult.com!
with eleven new chapters overlaying Cholangioscopy: Videocholangioscopy; Echoendoscopic Ultrasound; Endoscopic Ultrasound; mixed Biliary and Duodenal Obstruction; and more.
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Extra info for ERCP
Air bubbles are to be expected after sphincterotomy. Sometimes, such a large amount of air enters the duct that identiﬁcation of stones is no longer possible (see Fig. 4). In the case of precut sphincterotomy to access the duct, there will be no initial injection to clearly document the presence of stones prior to the introduction of air into the duct system. Paying particular attention to the shape and movement of intraductal ﬁlling defects may help distinguish between the two, even in this circumstance.
2 A ERCP cannulas (courtesy of Cook Endoscopy, Winston-Salem, NC). , Lehigh Valley, PA). B A 32 Pull type (Erlangen) sphincterotomes were originally designed for the performance of sphincterotomy. They consist of a Teﬂon catheter containing a continuous wire loop with 2–3 cm of exposed wire exiting at a variable distance from the tip (Fig. 5A). In precut sphincterotomes, the cutting wire extends to the tip (Fig. 5A). The other end of the wire is insulated and connected to an electrosurgical unit.
B Following injection of contrast into the main pancreatic duct, the radiopaque intraductal calciﬁcations are obscured by contrast. Parenchymal calciﬁcations should project apart from the opaciﬁed duct lumen; however in markedly dilated ductal systems the sheer caliber of the opaciﬁed duct may obscure even parenchymal calciﬁcation. C Corresponding abdominal CT image through the body of the pancreas shows parenchymal and ductal calciﬁcations in this patient. 21 SECTION 1 GENERAL TOPICS Fig. 8 ERCP drainage ﬁlm.
ERCP by Todd H. Baron MD FASGE, Richard A. Kozarek MD FASGE, David Leslie Carr-Locke MD FRCP FACG FASGE